Help! United HealthCare Coverage

[Guest guest]

Hi,

I just did consultation with my Orthodontist today, it turned out I

need

both upper and lower jaw surgery. When I asked whether my insurance

will cover the surgery cost, his answer is that according to his

experience to work with

the oral surgeon, my insurance company -- United HealthCare is the only

insurance company

that

will turn down a jaw surgery claim. Is this true? I think I saw

people

on this forum submit claim to United HealthCare, or is it just the

surgeon my Orthodontist work with is out-of-network? Is there anything

else I can do here? Please, someone

please help me with this, I desperately need the surgery to fix my

bite, I'm 35 years old, and I've waited for too long. Thanks a lot!

[Guest guest]

Hi ,

Unfortunately United Healthcare is not the only insurance company to

turn down jaw surgery. Many of them do it the first time around. If

you do get turned down, you can appeal several times and usually if

you're persistant, they will eventually give you approval.

I currently have United Healthcare and did get approval the first

time around but I have a friend who had to go through several

appeals. It took a lot of pressure from her company's HR department

but it finally went through. My situation was a little different

(severe degenerative arthritis of the TMJ joints requiring joint

replacement) so they couldn't deny me. They did refuse to pay in-

network because my surgeon is out of network. Supposedly there is a

surgeon in the area who is in network with them and maybe has done a

few joint replacements so they wouldn't budge on the out of network

approval.

Good luck and be persistant.

> Hi,

>

> I just did consultation with my Orthodontist today, it turned out I

> need

> both upper and lower jaw surgery. When I asked whether my

insurance

> will cover the surgery cost, his answer is that according to his

> experience to work with

> the oral surgeon, my insurance company -- United HealthCare is the

only

> insurance company

> that

> will turn down a jaw surgery claim. Is this true? I think I saw

> people

> on this forum submit claim to United HealthCare, or is it just the

> surgeon my Orthodontist work with is out-of-network? Is there

anything

> else I can do here? Please, someone

> please help me with this, I desperately need the surgery to fix my

> bite, I'm 35 years old, and I've waited for too long. Thanks a

lot!

>

>

[Guest guest]

Hi ,

Thanks a lot for your suggestion! I'll try to make it happen.

Have a nice weekend!

> > Hi,

> >

> > I just did consultation with my Orthodontist today, it turned out

I

> > need

> > both upper and lower jaw surgery. When I asked whether my

> insurance

> > will cover the surgery cost, his answer is that according to his

> > experience to work with

> > the oral surgeon, my insurance company -- United HealthCare is

the

> only

> > insurance company

> > that

> > will turn down a jaw surgery claim. Is this true? I think I saw

> > people

> > on this forum submit claim to United HealthCare, or is it just

the

> > surgeon my Orthodontist work with is out-of-network? Is there

> anything

> > else I can do here? Please, someone

> > please help me with this, I desperately need the surgery to fix

my

> > bite, I'm 35 years old, and I've waited for too long. Thanks a

> lot!

> >

> >